Cervical cancer, the fourth most common type of cancer affecting women worldwide, is also one of the most preventable types of the disease. It is caused by the human papillomavirus (HPV), the most common sexually transmitted infection.
“It is not a sexually transmitted disease (STD), but rather a sexually transmitted infection,” said Dr. Chia Yin Nin, a gynecological oncologist at Gleneagles Hospital, Singapore, who visited Manila recently.
“Anyone can have the virus—you can get it from both men and women. Everyone is a carrier, not just certain populations, she added.
HPV is sexually transmitted but not necessarily in a penetrative way. One can get it through intimate contact, such as petting, fondling or through an exchange of bodily fluids, primarily through skin-to-skin contact, Chia said.
An infection occurs when the virus enters the body through an abrasion, a cut or a small tear on the skin.
Genital HPV infections are contracted through sexual intercourse, anal sex and skin-to-skin contact in the genital region. The virus is spread by touching the skin of someone infected. Contact includes vaginal, anal and oral sex.
HPV is usually harmless and goes away on its own, but some lead to cancer and genital warts. “In the same manner that you can catch a cold and get well, but next time you catch a cold you might not be so lucky. You can get HPV and it can go away, but the next time it might stay,” she said.
There are more than 100 different types of HPV, most are low-risk and do not cause cervical cancer. The high-risk HPV types, those that cause cancer, are HPV-16 and HPV-18. Both are attributed to more than 70 percent of cervical cancer cases.
By the time they reach 50 years old, approximately 80 percent of women in the United States have been infected with some type of HPV. But the majority don’t get cervical cancer.
In developed countries, the cases of cervical cancer are on the decline primarily due to established HPV screening and vaccination programs. Australia is poised to wipe out cervical cancer by 2020, followed closely by Malaysia, said Chia.
The best way to prevent an infection is through screening and vaccination, Chia pointed out. “Cervical cancer doesn’t happen overnight. After the virus infection, it stays for years without the infected person knowing it unless she gets tested.”
The onset of the infection often does not have symptoms, so getting screened and tested are crucial. It’s the only way to detect infection.
Chia said a pap smear is not 100-percent reliable in HPV screening because it could yield a false negative result. But while it may not be the best, a pap smear can save lives. However, she advised going for the gold standard HPV test. Get a pap smear every year or every three years, she said, or an HPV test every three to five years. Some go for a combination of screenings.
Like any cancer, early detection is key to high survival. Detection of precancerous cells can easily be treated by burning the cells, Chia said.
New HPV vaccination is available for women from ages 9 to 45, although even the best vaccine is only 95 percent effective. That is why it is important to continue a screening routine even after vaccination.
Chia said that women who get the virus even after vaccination are most likely to have already been infected before the vaccination.
“Stop asking your partner to get tested. You might not be their first partner and vice versa. People are not very forthcoming when it comes to sexual habits. Vaccination is about empowering yourself and loving yourself,” Chia said.